Individual
ANASTASIYA DACKIV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
(844) 459-7529
Mailing address
8521 JEANES ST FL 1, PHILADELPHIA, PA 19111-1309
(267) 971-3138
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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